The Problem: The suicide rate in Nevada is nearly twice as high as the national average. Clark County, which includes Las Vegas, tops the suicide chart for U.S. counties with at least 1 million residents, with 18.74 suicides for every 100,000 people from 1999 to 2004, compared to 10.72 per 100,000 nationwide during that same period.
Grantee Perspective: Sociologist Matt Wray, PhD, joined the faculty at the University of Nevada, Las Vegas, after earning his doctorate in ethnic studies from the University of California, Berkeley. As a participant in Robert Wood Johnson Foundation Health & Society Scholars, Wray hopes to discover what lies behind the high suicide rate in Las Vegas. "There are things about this place that are worth looking at closely," says Wray.
Wray began his two-year interdisciplinary fellowship in 2006 at Harvard University, one of six universities participating in Health & Society Scholars. "The level of training, mentoring and individual support is just phenomenal," he says. "And I really like knowing I'm connected to a whole network of scholars who value interdisciplinary research."
Results: Wray's research includes an analysis of whether living in or visiting Las Vegas increases the risk for suicide. His preliminary findings show that living in Las Vegas is about twice as risky as living elsewhere. Even visiting the city is about twice as risky as visiting someplace else and 3.5 times riskier than staying at home.
Wray has identified five key risk factors for suicide in Las Vegas:
- Social isolation/low social capital (low levels of civic engagement and integration).
- Rapid population growth and demographic change.
- Problem gambling and alcohol and substance abuse.
- A high rate of psychiatric illness and low spending on services.
- A frontier culture (a "go-it-alone" mentality that stigmatizes asking for help and valorizes suicide).
Using theories and methods from geography, epidemiology, sociology and urban studies, Wray is mapping suicides by neighborhood and other factors, including race. He developed the database for this work through the Robert Wood Johnson Foundation's grant to Harvard as part of the funding to universities participating in Health & Society Scholars to help them develop population health research and teaching capacity.
Wray is also collaborating with the Nevada Coalition for Suicide Prevention and the Nevada Office of Suicide Prevention. The latter used Wray's work in developing the state's 2007 suicide prevention plan. Wray also wrote a report on Nevada suicide in 2006 for the University of Nevada, Las Vegas.
The Robert Wood Johnson Foundation Health & Society Scholars Program has enabled Wray to build up his quantitative research skills and to shift his focus to the intersection of the social and biological sciences.
"This program has given me the opportunity to pursue research that has important clinical and policy implications," says Wray, who hopes that his study of Las Vegas will lead to multi-city research that can be used to develop suicide prevention measures appropriate for local communities. Wray is now an assistant professor at Temple University.
RWJF Perspective: RWJF created Health & Society Scholars Program in 2001 to build the field of population health. "There's been a growing recognition that there are social, behavioral, environmental and economic, as well as biological, determinants of health," said Pamela G. Russo, MD, head of RWJF's Public Health Team.
"The program seeks to integrate paradigms and knowledge from a variety of disciplines to develop an understanding of how these determinants affect the health of populations, and thereby to design interventions with greater power to reduce health disparities," said Russo.